Cardiothoracic & vascular anesthesia
Single shot of intravenous iron in cardiac surgery: The ICARUS study
Authors' conclusion
Short-term pre-operative iron therapy is associated with a reduction in postoperative transfusions in anemic and non-anemic ID cardiac surgery patients and has a favorable impact on hospitalization costs.
Study context
- Population
- Candidates to elective cardiac surgery479 prospective and 833 retrospective cases included
- Participants
- 442 vs 442
- Exposure
- Prospective vs Controls
- Prospectiven = 442
- Controlsn = 442reference
- Outcome
- Proportion of patients requiring ≤1 packed red blood cell (RBC) unit
- Follow-up
- Within day 7 or discharge
Methodological detailspropensity score-matched, single-center, prospective and retrospective enrolment, Iron administered 1 day (IQR 1-2) before surgery
- Propensity score-matched
- Single-center
- Prospective and retrospective enrolment
- Iron administered 1 day (IQR 1-2) before surgery
Main finding
As reported in the abstract
≤1 pRBC transfusion
P = 0.014
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | |
|---|---|---|
| Multiple transfusions (risk) | 0.689 (0.510–0.930) | |
| 0.512Odds ratio (log scale) |
Iron deficiency (ID) prevalence among screened patients
- ID observed in screened patients
- 196 (44.3%)
- Iron administered before surgery, days (IQR 1-2)
- 1
Postoperative packed RBC (pRBC) transfusions
- Fewer in the prospective group, despite similar Hb at day 7
- P < 0.001
Hospital LOS
- Shorter in the prospective group
- P < 0.001
Hospitalization costs
- Lower in patients screened and treated for ID
Original publication
Single shot of intravenous iron in cardiac surgery: The ICARUS study. J Clin Anesth. Published 16 November 2022. doi:10.
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